Winged Scapula

Winged scapula

A winged scapula is where the shoulder protrudes out of the back rather than laying flat against the back of the chest wall. It is a symptom of another condition, rather than an injury itself but can be painful.


Winged scapula symptoms

  • A winged scapular is usually fairly obvious as the scapular or shoulder blade protrudes outwards sticking out of the back.
  • Patients can complain of shoulder blade pain with pressure on the scapular from a chair when sitting.
  • If caused by an injury resulting in nerve damage, the patient may have limited shoulder elevation as well as shoulder blade pain.

What causes a winged scapula?

A winged scapula is a symptom of another condition, rather than an injury itself. The shoulder blade protrudes outwards from the back, rather than laying flat against the back of the chest wall.

It is quite a common shoulder dysfunction, also associated with poor posture. It is called winged scapula because the medial (inner) border of the scapula appears wing-like on the back.

A winged scapula sometimes occuts following a contusion to the long thoracic nerve of the shoulder, and/or Serratus Anterior muscle weakness. If you damage the long thoracic neve, the serratus anterior muscle becomes paralysed.

As a result, winging of the scapular or shoulder blade occurs. Direct trauma causes nerve damage. However, symptoms sometimes follow a viral illness.

Winged scapula treatment

Apply ice or cold therapy to reduce the shoulder blade pain.

A full rehabilitation and strengthening program consisting of exercises for the shoulder is important. The most important muscle to strengthen if you have a Winged scapular is the serratus anterior muscle. It is the one which holds the shoulder blade in place.

Exercises to strengthen the serratus anterior or are punching-type exercises. This is why we call it the punching muscle.

Seek professional advice, particularly if your shoulder does not respond to strengthening exercises. Initial treatment is usually conservative. Occasionally surgery is needed if this fails and the condition is caused by nerve entrapment.

Winged Scapula Exercises

A winged scapula is usually a result of weakened shoulder blade stabilisers, especially the Serratus Anterior. The serratus anterior is also known as the punching muscle.

To target the Serratus Anterior directly, scapula protraction exercises work best along with serratus press exercises. Any movement which protracts the shoulder forwards at the end range of movement will target the serratus anterior. Punching a punch bag will also work this muscle.

Scapula protraction

Start with the end of the band in one hand at shoulder height, elbow bend. Push the hand forwards, straightening the elbow as you go, in a punching motion. Ensure you push through the entire shoulder, trying to reach as far forward as possible. Slowly return the hand to the starting position under complete control.

Serratus press

Start in a lying position as shown, with a medicine ball in both hands, elbows straight. Keep the elbows straight throughout the exercise. Push the ball up, using only the shoulder girdle to move it. Lower the shoulders back down and repeat.

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